Cervical cancer in the region can be eliminated

In 2008, Abu Dhabi embarked on an ambitious journey to eliminate the human papillomavirus (HPV), a major cause of cervical cancer, from its population. It was the first in the Eastern Mediterranean Region (EMR) to introduce the HPV vaccine in its national immunisation programme, providing it for free to all 11-12 year-old girls. This was a bold and visionary decision. Fifteen years later, cervical cancer remains a major health threat in the EMR. In 2020, an estimated 89,800 women were diagnosed with cervical cancer in the region and more than 47,500 women died from this preventable disease. As a woman and as a public health professional, I have a personal connection to this issue, and I hope to see all girls from the region live without fear of cervical cancer. While acknowledging the challenges, it is important to take a moment to celebrate the progress made towards eliminating HPV and cervical cancer in the EMR. In 2018, UAE introduced HPV vaccines in its national immunisation programme for the whole country. I am proud to say that several countries in the region, including Saudi Arabia, Libya and Morocco, have followed the path and introduced the HPV vaccine in their own national immunisation programmes and a few other countries are in the process of doing so. This demonstrates the increasing political will in the region towards the elimination of the disease. The momentum was only spurred by the launch of the World Health Organisation (WHO) Regional Cervical Cancer Elimination Strategy for the EMR earlier this year. This regional strategy is specifically tailored to the epidemiologic and sociocultural context of our countries. It will enable progress towards the 2030 targets set by the WHO in the Global Strategy for Cervical Cancer Elimination. Its ultimate goal is to reduce the burden of cervical cancer in the EMR by decreasing its incidence and mortality by 90 per cent in 2030. The regional strategy focuses on providing equitable access to prevention, diagnosis, treatment and palliative care services for all women in the EMR. It provides guidance to all countries in the region around five key actions: HPV vaccination, cervical cancer screening , strengthening infrastructure and access for early diagnosis, treatment and palliative care, ensuring cervical cancer prevention and control are integrated and sustained within the overall health system, and raising awareness and educating the public on cervical cancer prevention, early detection and treatment. It is critical to prioritise HPV vaccination, as it is the most effective tool for prevention of cervical cancer. WHO and its partners are ready to support the countries that still have not yet launched an HPV vaccination programme, leaving millions of girls and women at risk. We must work to ensure that all girls, regardless of their socioeconomic status or geographic location, have access to this life-saving vaccine. Meanwhile, early cervical cancer screening is essential. Regular screening can detect precancerous lesions when they are still treatable, but many women in low-and middle-income countries do not have access to this critical health service. We need to invest in innovative approaches to screening, such as self-sampling and point-of-care testing, to ensure that all women can benefit from this life-saving tool. All women diagnosed with cervical cancer need to have access to the care they need and we need to ensure this. This includes not only treatment for the cancer itself, but also palliative care to manage symptoms and improve quality of life. We must work to improve access to cancer care, including through the development of national cancer control plans. Raising awareness and educating the public on cervical cancer prevention and the role of HPV vaccination is critical to achieving the 2030 targets. Communication, advocacy, and social mobilisation efforts are needed to build trust with communities, particularly those in underserved areas. We must also acknowledge and tackle vaccine hesitancy and resistance, which is often maintained by misconceptions and socio-cultural barriers, particularly in underserved communities. Communication especially designed to address myths and campaigns to educate are necessary to bring down barriers and ensure equitable access to prevention and treatment services. To achieve the success of the regional strategy for cervical cancer elimination, sustained political commitment is essential. This requires reinforcing health systems and ensuring appropriate resource mobilisation to support prevention, treatment and palliative care services. It also requires the involvement of civil society, academia, the private sector, as well as international organisations and donors. Scaling up the regional strategy for cervical cancer elimination is not only crucial for achieving HPV elimination but also for addressing other public health burdens in the region. It is crucial to continue working together towards the implementation of the regional strategy to save countless lives and strive for a future where cervical cancer is no longer a threat to communities. Through our collective efforts, we can ensure health for all in the Eastern Mediterranean Region and beyond.